Sample_Change_Order.pdf

This document is a Sample Change Order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed to facilitate modifications to existing contracts. The form provides a standardized framework for documenting changes to project scope, budget, or other contractual elements, with designated spaces for fiscal number, change order number, account number, and financial adjustments including total agreement amount, additions, deletions, and new total agreement value.

The change order template includes critical provisions that require contractor acknowledgment, specifically stating that execution of the change order constitutes a waiver of additional time or compensation claims for activities prior to the change order's execution. The document requires signatures from multiple parties, including an investigator, Director of Purchasing, County Attorney, Board of County Commissioners Chairman, County Clerk, and the contractor, ensuring comprehensive review and formal approval of any contract modifications. The template is part of the broader FY 2026 Pavement Preservation Package 1, which involves roadway improvements across five locations in Pinellas County, totaling approximately 34.98 lane miles.